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a Direction of Education and Research, Hospital de Especialidades Centro Médico La Raza, Instituto Mexicano del Seguro Social, Mexico City, Mexico b Universidad Nacional Autónoma de México, Hospital de Especialidades Centro Médico La Raza, Instituto Mexicano del Seguro Social, Mexico City, Mexico c Clinical and Epidemiological Research Unit, Hospital de Especialidades Centro Médico La Raza, Instituto Mexicano del Seguro Social, Mexico City, Mexico d Epidemiology Department, Hospital de Especialidades Centro Médico La Raza, Instituto Mexicano del Seguro Social, Mexico City, Mexico e Obstetrics and Gynecology, Hospital de Gineco-Obstetricia No. 3, Hospital de Especialidades Centro Médico La Raza, Instituto Mexicano del Seguro Social, Mexico City, Mexico f Rheumatology Department, Hospital de Especialidades Centro Médico La Raza, Instituto Mexicano del Seguro Social, Mexico City, Mexico
Key Words: prolactin • lupus anticoagulant • lupus pregnancy outcome
Address for correspondence: Luis J. Jara, Direction of Education and Research, Hospital de Especialidades Centro Médico La Raza, IMSS, Seris/Zaachila S/N, Colonia La Raza, CP 02990 Mexico City, Mexico. Voice: +5255-57245900; ext.: 23015; fax: +5255-55977881. luis_jara_quezada{at}hotmail.com
High prolactin (PRL) levels seem to be associated with active systemic lupus erythematosus (SLE) during pregnancy. However, the association of activity, lupus anticoagulant (LA), and pregnancy outcome has not been analyzed. The objective of this study was to analyze the association among SLE activity, LA, and maternal–fetal outcome. We studied 15 pregnant SLE patients (ACR criteria), 4 of them with associated antiphospholipid syndrome (APS), and 9 healthy pregnant women. All patients were evaluated monthly with the following determinations: (a) SLE activity using modified-systemic lupus activity measurement (m-SLAM), (b) LA, and (c) PRL serum levels. Healthy controls were evaluated each trimester. Prematurity, fetal loss, low birth weight, and preeclampsia were evaluated. Chi-square test, Fisher's exact test, Student's t-test, Pearson correlation, and ANOVA were performed. The mean age of SLE patients was 30 ± 4.9 years and 27.1 ± 3.7 years in controls. High PRL levels were found during the second and third trimester in SLE patients in comparison with controls (186.2 ± 54.02 ng/mL versus 119.6 ± 31.1 ng/mL (P < 0.01) and 177.4 ± 48.6 ng/mL versus 158.3 ± 31.5 ng/mL. A significant linear correlation between PRL, m-SLAM, and LA in association with poor maternal–fetal outcome was observed. LA and PRL conferred risk for poor pregnancy outcome. Our study indicates for the first time a strong association among PRL, LA, SLE activity, and poor pregnancy outcome. Close rheumatologic and obstetric monitoring is mandatory in SLE pregnancy in order to avoid obstetric complications.
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